Individual
DR. LARRY ROYCE HUTSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2401 S 31ST ST, TEMPLE, TX 76508-0001
(254) 724-2111
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(254) 724-2111
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
026179
LA
207L00000X
Anesthesiology Physician
MD026179
LA
207L00000X
Anesthesiology Physician
Primary
N1352
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03823244
—
MS
05
—
1050024
—
LA
Enumeration date
07/07/2005
Last updated
11/29/2021
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